Guidelines For Clinical Pharmacy Practice PDF

GUIDELINES/STANDARDS FOR CLINICAL PHARMACY PRACTICE Clinical pharmacists practice in many different health care environments: hospitals and their affiliated outpatient clinics emergency departments community pharmacies physicians’ offices, community-based clinics nursing homes...

GUIDELINES/STANDARDS FOR CLINICAL PHARMACY PRACTICE Clinical pharmacists practice in many different health care environments: hospitals and their affiliated outpatient clinics emergency departments community pharmacies physicians’ offices, community-based clinics nursing homes I- Qualifications The Clinical pharmacists are practitioners who provide comprehensive medication management and related care for patients in all health care settings. They must possess the following qualifications: Qualification (degree of Pharmacy) to become licensed pharmacist. Specialized advanced education and training in clinical competencies needed to practice in team-based, direct patient care environments. Accredited residency training or equivalent post-licensure experience required for entry into direct patient care practice. Certification from Board of Pharmacy Specialties (BPS). II- Process of Care Clinical pharmacists work in collaboration with other health care providers to deliver comprehensive medication management in order to optimize patient outcomes. Pharmaceutical care is that component of pharmacy practice which entails direct interaction of pharmacist with patient for the purpose of caring patient’s drug related needs. KEY ELEMENTS OF CARE PROCESS The clinical pharmacist’s process of care consists of under- mentioned components: A) Assessment of clinical status of patient The clinical pharmacist assesses the medication needs of the patient by:  Reviewing the medical records by interpreting and analyzing subjective and objective information.  Meeting with the patient/caregivers to record a complete medication history to identify all of the patient’s current medications (including regimens and administration routes), medication-taking behaviors, adherence, allergies, and attitudes and experiences with medication therapy  Obtaining, organizing, and interpreting patient data  Prioritizing patient problems and medication-related needs B) Evaluation of medication therapy The clinical pharmacist identifies strategies to make most effective use of medication therapy by:  Assessing the appropriateness of current medications on the basis of health conditions, indications, and the therapeutic goals of each medication by consulting with other members of the health care team  Evaluating the efficacy, safety, and affordability of each medication  Assessing medication-taking behaviors and adherence to each medication  Identifying medication-related problems and evaluating collaboratively with other members of the health care team the need for intervention. C) Development and implementation of a care plan The clinical pharmacist, in collaboration with patient and his/her health care providers, develops and implements, a plan for optimizing medication therapy by:  Reviewing the patient’s active medical problems to develop an individualized assessment and plan for optimizing medication therapy;  Prepare and implement a comprehensive medication management plan to achieve patient-specific outcomes;  Educating the patient/caregivers (both verbally and in writing) to ensure understanding of the care plan, to optimize adherence, and to improve outcomes;  Establishing patient-specific measurable parameters and time frames for monitoring and follow-up in collaboration with other members of the health care team. D)Follow-up evaluation and medication monitoring The clinical pharmacist, collaboratively with other members of the health care team, performs follow-up evaluations to continually assess patient outcomes by:  Coordinating with other health care providers to ensure that patient follow-up and future encounters are aligned with the patient’s medical and medication-related needs;  Rechecking the medical records and then meeting with the patient/caregivers to get an updated medication history to identify and document any new medication-related needs or problems;  Conducting ongoing assessments and refining the plan of care to optimize medication therapy and ensure that individual goals are achieved; and  Monitoring, modifying, documenting, and managing the plan of care in collaboration with the patient/caregivers and his/her other health care providers III)- Documentation Clinical pharmacists document directly in the patient’s medical record the medication-related assessment The following components of the encounter are essential to be included in the documentation, which may be communicated in the form of a traditional SOAP (subjective data, objective data, assessment, plan) note or other framework that complies with the standards of documentation within the practice setting. A) Medication history  As an introduction to the documentation, a brief summary of the patient’s past medication use and related health problems;  Listing of all current medications including, adherence, and attitudes toward therapy; and  Making a list of medication-related allergies and any adverse drug effects that may influence prescribing and monitoring or interrupt the future use of a medication. B) List of Active problems with assessment of each problem  A listing of current health conditions with emphasis on associated medications and medication-related problems that may affect the desired goals; and  A listing of any additional medication-related problems or other medical issues that may be unrelated to current health conditions. C) Plan of care to optimize medication therapy and improve patient outcomes  Specific medication therapy plan that has been or will be implemented collaboratively by the health care team, including drug, dose, dose regimen, route of administration, and relevant monitoring parameters.  Plan for follow-up evaluation and monitoring as well as future visits. IV- Collaborative, Team-Based Practice and Privileging Clinical pharmacists, as members of the health care team, work in collaboration with other health professionals to provide high-quality, coordinated, patient-centered care. They establish written Collaborative Drug Therapy Management (CDTM) agreements with individual physicians, medical groups, or health systems and/or hold formally granted clinical privileges from the medical staff or system of the organization in which they practice. These privileging processes confer certain authorities, responsibilities, and accountabilities to the clinical pharmacist as a member of the health care team and contribute to the enhanced efficiency and effectiveness of team-based care. V- Professional Development and Maintenance of Competence Clinical pharmacists maintain competence in clinical problem-solving, judgment, and decision-making; communication and education; medical information evaluation and management; management of patient populations; and a broad range of therapeutic knowledge domains. Clinical pharmacists maintain competency through: A)Certification and maintenance of certification in the appropriate specialty relevant to their practice, including those specialties recognized by the Board of Pharmacy Specialties (BPS) or other nationally recognized multiprofessional certifications; B) Continuous participation in continuing professional development (CPD) activities that enhance direct patient care practice abilities; and C) Maintenance of active licensure, including required continuing pharmacy education activities, through the appropriate state/country board(s) of pharmacy (such as NAPLEX in America, PEBC in Canada), DHA in dubai, MOH in Sharjah, HAAD in Abu dhabi, APC (Australian Pharmacy Council Exams): Required for international pharmacy graduates. Includes the Knowledge Assessment of Pharmaceutical Sciences (KAPS) and an intern training program, followed by a registration exam. VI- Research and Scholarship Clinical pharmacists support and participate in research and scholarship to advance human health and health care by developing research questions; conducting or participating in clinical and health services research; contributing to the evolving literature in evidence-based pharmacotherapy; and/or disseminating and applying research findings that influence the quality of patient care. VII- Other Responsibilities Clinical pharmacists serve as direct patient care providers, but they may also serve as educators, researchers, clinical preceptors( teacher or instructor)/mentors(experienced and trusted adviser), administrators, managers, policy developers, and consultants. As the clinical pharmacy discipline grows, it must continue to familiarize more patients, families, caregivers, other health professionals, health care administrators, students and trainees with the full range of clinical pharmacists’ responsibilities.